Guidelines for Patient-Centered Medical Home (PCMH) Recognition and Accreditation Programs

Abstract

The patient-centered medical home model facilitates ideal primary care and therefore recognition and accreditation programs should attempt to assess all of the primary care domains outlined by the IOM—comprehensiveness, coordination, continuity, accessibility, and patient engagement and experience. This will further ensure that every recognized or accredited entity provides care consistent with the Joint Principles, including, but not limited to, having a whole person orientation which means taking responsibility for coordinating each patient's full array of health care services using a team-based approach—i.e., delivering care for all stages and ages of life, acute care, chronic care, behavioral and mental health care, preventive services, and end of life care—and coordinating and/or integrating care for services not provided by the PCMH across all elements of the complex health care system (e.g., subspecialty care, hospitals, home health agencies, nursing homes) and the patient's community (e.g., family, public and private community-based services). 3. Ensure the Incorporation of Patient and Family-Centered Care Emphasizing Engagement of Patients, their Families, and their Caregivers A commonly accepted definition of " patient-centered care " also is provided by the IOM: Patient-centered care is " healthcare that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients' wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care " (IOM, 2001). Therefore, recognition and accreditation programs for the patient-centered medical home should attempt to incorporate elements that assess a practice's or organization's ability to implement patient-and family-centered care based on the needs and preferences of their patients, family, and caregivers; incorporate shared-decision making; encourage and support self-management and self-care techniques; facilitate complete and accurate information sharing and effective communication; encourage active collaboration of patients/families in the design and implementation of delivery of care; ensure cultural and linguistic competency among its clinicians and staff; and collect and act upon patient, family, and caregiver experience and satisfaction data. There should also be special considerations to align program standards, elements, characteristics, and/or measures with populations that have specific needs such as the pediatric and geriatric populations.